Effect of intrathoracic pressure on plasma arginine vasopressin levels
| Autor: | Amelia Gonzalez, Gregorio Castellano, Diego Moreno, Joaquin Gutierrez, J.A. Solis-Herruzo, Luisa Larrodera, Adolfo Gozalo |
|---|---|
| Rok vydání: | 1991 |
| Předmět: |
Adult
Liver Cirrhosis Male medicine.medical_specialty Vasopressin Arginine Punctures Plasma renin activity chemistry.chemical_compound Pneumoperitoneum Internal medicine Ascites Pressure medicine Humans Blood Volume Aldosterone Hepatology business.industry Gastroenterology Pneumothorax Middle Aged Thorax Atrial Function medicine.disease Arginine Vasopressin Pleural Effusion Endocrinology chemistry Female medicine.symptom business Hyponatremia Pneumoperitoneum Artificial Antidiuretic |
| Zdroj: | Gastroenterology. 101:607-617 |
| ISSN: | 0016-5085 |
| DOI: | 10.1016/0016-5085(91)90516-n |
| Popis: | Abdominal distention during pneumoperitoneum results in a marked increase in plasma arginine vasopressin levels, which has been ascribed to an increase in intrathoracic pressure. Because of this relationship, tense ascites could contribute to nonosmotic release of antidiuretic hormone, to the development of hyponatremia, and eventually to further ascites formation. The effect of pneumoperitoneum, thoracocentesis, and paracentesis on plasma arginine vasopressin levels was studied in three groups of patients, and the mechanism by which these maneuvers may induce these changes was investigated. Patients with pleural effusion, pneumothorax, or ascites showed a significant increase in plasma arginine vasopressin levels, and thoracocentesis or paracentesis resulted in a decrease in these levels. Plasma vasopressin levels increased significantly during pneumoperitoneum, as did intrathoracic and atrial pressures; the atrial transmural pressure gradient declined. However, no changes in plasma levels of norepinephrine, aldosterone, and renin activity were observed during pneumoperitoneum. Changes in plasma arginine vasopressin levels correlated with the changes in intrathoracic and atrial pressures and transmural pressure gradient. The authors conclude that increased intrathoracic pressure is associated with an increase in plasma arginine vasopressin levels and propose that ascites could be a factor promoting vasopressin release by acting on intrathoracic volume receptors in decompensated cirrhotics. |
| Databáze: | OpenAIRE |
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